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高龄老年人非静脉曲张上消化道出血的临床特点分析(1)
http://www.100md.com 2015年2月15日 中国当代医药2015年第5期
     [摘要] 目的 探讨和分析老年急性非食管静脉曲张性上消化道出血的临床特点。 方法 选取2013年8月~2014年10月来本院治疗的急性非食管静脉曲张性上消化道出血160例患者作为研究对象,分成两组,观察组80例为老年患者,对照组80例为非老年患者,对于出血症状,均给予抑酸、止血、补液等治疗,止血采用喷洒去甲肾上腺素和凝血酶粉,对比两组的临床疗效、病情及出血原因。 结果 观察组优良率为75%,对照组优良率为95%,差异有统计学意义(P<0.05)。观察组的临床症状以单纯黑便和低血压休克为主、呕血黑便为辅,与对照组比较差异有统计学意义(P<0.05)。观察组的出血原因以癌症为主,对照组以急性胃黏膜病变和贲门黏膜撕裂为主,差异有统计学意义(P<0.05)。 结论 老年患者出现急性非食管静脉曲张性上消化道出血病情一般较重,治疗后疗效不佳,需临床医生予以重视并采取相应手段进行治疗。

    [关键词] 急性上消化道出血;老年患者;临床特点

    [中图分类号] R573.2 [文献标识码] A [文章编号] 1674-4721(2015)02(b)-0032-03

    Analysis of the clinical characteristic on elderly patients with actute non-gastrointestinal bleeding varices

    LI Rui LAN Yong-zhen LAI Ri-hui ZHANG Cui-lu

    Department of Gastroenterology,People′s Hospital of Yingde City in Guangdong Province,Yingde 513000,China

    [Abstract] Objective To investigate and analyze the clinical characteristic of elderly patients with acute non-variceal upper gastrointestinal bleeding. Methods 160 patients with upper gastrointestinal hemorrhage in our hospital from August 2013 to October 2014 were selected as the research objects and divided into two groups,observation group(80 cases)of elderly patients and control group(80 cases)of non-elderly patients.For bleeding,acid suppression,hemostasis,infusion treatment,hemostasis with norepinephrine and thrombin powder spraying were applied.And the clinical efficacy,patients condition,bleeding reason of two groups were compared. Results Excellent rate in observation group was 75%,excellent rate in control group was 95%,with statistical difference(P<0.05).The clinical symptoms of observation group with simple black and hypotensive shock mainly,supplemented with hematemesis melena,there was statistical difference compared with control group(P<0.05).The cause of bleeding in observation group with cancer mainly,cause of bleeding in control group with acute gastric mucosal lesion and mallory weiss mainly,with statistical difference(P<0.05). Conclusion Elderly patients with acute non-variceal upper gastrointestinal bleeding condition generally heavier,treatment efficacy is poor,the clinicians need pay much more attention and take corresponding measures for the treatment.

    [Key words] Acute upper digestive tract bleeding;Elderly patient;Clinical characteristic

    上消化道出血是指屈氏韧带以上的消化道,包括食管、胃、十二指肠或胰胆等病变引起的出血。临床主要表现为呕血和(或)黑便,往往伴有血容量减少引起的急性周围循环衰竭,是常见的急症,病死率高达8%~13.7%。老年人急性上消化道出血病情复杂[1-5],分析其临床特点,有助于提高临床治愈率。选取本院收治的急性非食管静脉曲张性上消化道出血160例为研究对象,分析其临床特点。

    1 资料与方法

    1.1 一般资料 (李睿 蓝永贞 赖日辉 张翠禄)
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